Friday, September 30, 2011

First Week

Arrived in Porto at last !!!

It was hectic week getting here. I just had finished my rotation at Johns Hopkins in Baltimore and was scheduled to fly out Monday morning from NC. Just enough time to finally spend a few hours with my best friends, who are now residents at JHU, drive down to NC, do a month's worth of laundry, re-pack, and head out on this adventure.

The flight from NC to Miami went pretty smoothly. However the main flight from Miami to Madrid could have been better. I was the genius who picked a seat online that ended up having some component box under the seat in front, which took up 1/4 of my leg room. Great for an overnight transatlantic flight. Should have consulted

I also ended up sitting next to a nice Spanish lady who proceeded to tell me her whole life story in Spanish after she took 3 Xanax, and I told her that I knew "poco espanol. "

The flight took off an hour and half late first due to lack of fuel and then maintenance issues. Slightly unnerving for a transatlantic flight. I finally managed to get to sleep dreaming of ending up on an island in the middle of the Atlantic and the TV series LOST.

When we got to Madrid, I was given a priory connection slip to help me get to my connection to Porto faster, since the flight was scheduled to leave in less than an hour. It would have been useful if the gate agent told me where to go instead of saying, "follow the signs." What signs? Turns out that I have to get my passport stamped in Spain, not Portugal. Something to keep in mind for those of you in the future, you get your passport stamped as you enter the EU. Then I had to change terminals and redo security. Whew...made it to the gate drenched in sweat, and the plane is still there.

I slept most of the short flight, and things are starting to look up. While waiting for my bags to come out in the porto baggage claim (yes they made the short connection time as well), some workers from porto tourism come give us welcome bags with a map, list of things to do, and a hat. Nice...The porto airport is very nice; pretty much walked through customs and there are signs everywhere on how to get to the center city. My counterparts that went on this rotation before all took the metro to world spru (the dorm that we stay in). However, I took a cab, which cost 20 euros to get from the airport to the front door of spru. I did this because I had packed a carry on, my unc messenger bag with the lovely 8lb UNC laptop, and a 36 in giant suitcase that my parents had gotten to travel to India. No way this was going to be an easy feat on the metro. More on if I over-packed to come ....

The drive from the airport was nice. My cab was a Mercedes Sclass sedan; the driver had a radio station that played a mix of red hot chilly peppers to "somewhere over the rainbow." It was nice to see the landscape around city, which was interesting since the trees/forest is similar to NC, but with palm trees mixed in. Made it to the dorm and checked into my room around 3 Porto time, which is around 10 eastern time. Pretty much just settled in and got ready for my trip to the hospital in the AM.

I left the dorm in Campanha at 700 with the hopes to arrive and meet Dr. Basto at 830. The nice part is that the dorm is attached to the station so there's a walk along the building and then down an elevator and metro. I stood in line for to buy a card and just stuck some money in the machine and hoped it was enough. I took the train from Campanha to Trindad (equal to metro center in DC for those of you that are familiar with that system) and went down the escalator where I saw signs for the train to Hospital Sao Jao. The trains come pretty quickly so you don't have to wait that long for the next one. Made it to the hospital lobby in 30 minutes. Its only 730. Guess I'll get some coffee from the cafe that they have and play some angry birds on my phone.

Note for future students: I have AT&T, so was able to buy a package before I left that would let me make calls but will still charge per minute for emergencies, but I can also send 200 text messages to the states, so I have been using this to communicate back home. You will also get a SIM card here from the ERASMUS coordinator in the hospital, just make sure you bring a spare phone that has been unlocked by your carrier to accept foreign SIM cards.
The Hospital on my first day

I meet Dr. Basto and go to his office. We discuss my plans and some things to do in Porto before taking me to meet my team, Med B on the women's floor. The Hospital was built in 1959 and they are working on renovating most of it (mainly a major work in progress). By some glitch my attending was out this day and so as a back up plan, I spend the day with Med A. The team is very nice and we round on the patients and wait to discuss with the attending in the late morning. A team consists of the attending, an internal medicine resident, and 6th year (final year) medical students who essentially function like interns. A typical day is from 8 - 2ish. Plenty of time to go explore the city/recover from jet lag.

Second day. I meet with Dr. Basto again, after only getting lost in the hospital once because a door was closed that was open yesterday, and we go meet Med B, which functions essentially the same as Med A. One of the major differences that I see between the US system and here is the number of patients on a team and the amount of time spent talking with them. The nurses also play a very integral part in the patient's care. We stop to update the nurse taking care of our patient on the plan multiple times.

Day 3. Its Friday...Friday...Friday...Friday....tomorrow is Saturday... Today was a little different since our attending had to leave at 830 to take care of something with his car. To be honest, I wasn't sure really what he said. Everyone understands or speaks English in the hospital but sometimes things get lost in translation. Our resident had also worked overnight in the ED as a consults person. Here the system is that there is a resident in the ED that sees all of the consults and decided to admit them or not. The ones that are admitted go to whichever team is next to take a patient. So each morning you have to check in the log at reception to see if there are any new admits for your team. Anyway, as I come in, the nurse rushes in and what I believe tells the resident to come quick. Our 103 y/o lady with CHF is tachypnic and has a fever of 40 C. She was doing so much better yesterday and actually answered our questions; now florid sepsis. We start her on high flow oxygen and fluids. She had gotten abx last now we wait. In the mean time the med student and I go see the other patients, who all also have low o2 saturations, which means I get to perform an ABG. Pretty exciting AM in the hospital. Things quiet down after the coffee break with the other med teams, and I head out around 1. I stop off in the city center to visit the porto tour office and have some lunch. I have a pretty exciting weekend planned. A hike along the beach from matoshinos to foz where the river meets the Atlantic on Saturday and then one of those open top bus tours of the city on Sunday.

The Busy Streets of Porto

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